Custom Quality Services, Inc.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

CUSTOM QUALITY SERVICES, INC.

Practice address

3401 Jewell Ave
Louisville, KY 40212-2139

Phone

(502) 772-7383

Fax

(502) 772-7387

NPI assigned

Nov 13, 2008

Last updated

Nov 13, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Phillip Reid Berry, BA

Title

President and Ceo

Phone

(502) 772-7383

Specialties & licenses 2

Addresses

Other names 1

• Custom Manufacturing, Inc. Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1226534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226534400000",
    "number": "1487808721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 JEWELL AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402122139",
            "telephone_number": "502-772-7383",
            "fax_number": "502-772-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 JEWELL AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402122139",
            "telephone_number": "502-772-7383",
            "fax_number": "502-772-7387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM QUALITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-13",
        "last_updated": "2008-11-13",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "REID",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "502-772-7383",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Custom Manufacturing, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Developmentally Disabled Services Day Training Agency in Louisville, KY
• Providers in Louisville, KY by specialty
• Developmentally Disabled Services Day Training Agency in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.